Tonsillectomy: When is it Necessary?

Many older adults today have had a tonsillectomy (surgical removal of the
tonsils at the back of the throat). The frequency of tonsillectomy procedures
peaked in popularity from the late 1950s through the 1970s as a treatment for
children with frequent or recurring
sore throats (tonsiliitis). Since the heyday of
tonsillectomy in the 70s, the tonsillectomy rate has declined by about 75%, from
about 1 million per year to just around 250,000. The reason for this decline is
a growing skepticism on the part of both doctors and parents that the procedure
has benefit for most people in helping control infections. Even a major research
study in 2004 showed that many, if not most, tonsillectomies, might not be
neccessary at all.

The operation itself is a fairly simple procedure with relatively few risks
of serious consequences. Still, infection, bleeding, and complications from the
anesthetic drugs are a potential risk of any surgical operation. Most children
who have a tonsillectomy will need to miss at least a week of school, and there
is usually some degree of discomfort in the days following the procedure.

While doctors may still debate the necessity for tonsillectomy and its
effectiveness as a treatment, there are certain circumstances for which the
tonsillectomy is definitely recommended, including:

Sleep apnea, a condition in which breathing is temporarily interrupted
at night. Sleep apnea can be caused by markedly enlarged tonsils and is
usually accompanied by
heavy snoring

Any degree of airway obstruction or swallowing problems caused by
enlarged tonsils

Any suspicion of cancer (very rare) in the area or another need for a
biopsy to establish a diagnosis

In other situations, such as a high frequency of throat infections (more than
5-6 sore throat infections per year) or very severe infections, a tonsillectomy may be considered. The
type and severity of infections as well as their response to antibiotics is
taken into consideration when deciding whether a tonsillectomy might be
appropriate for an individual patient.